Abstract

Chronic kidney disease (CKD) has attracted considerable attention in the public health domain in recent years. Researchers have exerted considerable effort in attempting to identify critical factors that may affect the deterioration of CKD. In clinical practice, the physical conditions of CKD patients are regularly recorded. The data of CKD patients are recorded as a high-dimensional time-series. Therefore, how to analyze these time-series data for identifying the factors affecting CKD deterioration becomes an interesting topic. This study aims at developing prediction models for stage 4 CKD patients to determine whether their eGFR level decreased to less than 15 ml/min/1.73m2 (end-stage renal disease, ESRD) 6 months after collecting their final laboratory test information by evaluating time-related features. A total of 463 CKD patients collected from January 2004 to December 2013 at one of the biggest dialysis centers in southern Taiwan were included in the experimental evaluation. We integrated the temporal abstraction (TA) technique with data mining methods to develop CKD progression prediction models. Specifically, the TA technique was used to extract vital features (TA-related features) from high-dimensional time-series data, after which several data mining techniques, including C4.5, classification and regression tree (CART), support vector machine, and adaptive boosting (AdaBoost), were applied to develop CKD progression prediction models. The results revealed that incorporating temporal information into the prediction models increased the efficiency of the models. The AdaBoost+CART model exhibited the most accurate prediction among the constructed models (Accuracy: 0.662, Sensitivity: 0.620, Specificity: 0.704, and AUC: 0.715). A number of TA-related features were found to be associated with the deterioration of renal function. These features can provide further clinical information to explain the progression of CKD. TA-related features extracted by long-term tracking of changes in laboratory test values can enable early diagnosis of ESRD. The developed models using these features can facilitate medical personnel in making clinical decisions to provide appropriate diagnoses and improved care quality to patients with CKD.

Notes

Compliance with Ethical Standards

Conflicts of Interest

Authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Written consent from the study was unavailable because the dataset comprises only de-identified secondary data for research purposes, and the Institutional Review Board of St. Martin de Porres Hospital issued a formal written waiver of the need for consent and approved the study.